Background
Pyuria is often used as an important marker in the diagnosis of urinary tract infection . The interpretation of pyuria may be especially important in patients with nonspecific symptoms. There is a paucity of data demonstrating the usefulness of pyuria alone in the diagnosis of bacteriuria or urinary tract infection .
This study aims to better define the relationship between pyuria and positive bacterial growth in urine culture, as well as the diagnostic usefulness of different cut-off points for white blood cells in urine.
Method
A total of 46,127 patients over the age of 18 years were selected from the inpatient population of the Capital Division of the HCA Healthcare System. Urine microscopy results were stratified by white blood cell count and correlated with urine culture bacterial growth positivity. The optimal limit of urinary white blood cells was obtained based on the receiver operating characteristic curve plot.
Results
The finding in urine microscopy of white blood cells of 0 to 5 cells/hpf, 5-10 cells/hpf, 10-25 cells/hpf and more than 25 cells/hpf was associated with 25.4%, 28.2%, 33% and 53.8% bacteriuria rates, respectively.
(Reference hpf : high power field (microscope))
The receiver operating characteristic curve plot demonstrated that pyuria alone did not provide adequate diagnostic accuracy for predicting bacteriuria .
The optimal cutoff point for the best combination of sensitivity and specificity was found to be 25 cells/hpf.
Conclusion
|
